Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic health condition that significantly affects the autonomic nervous system, particularly impacting heart rate and blood pressure regulation.
This blog post delves into the symptoms, potential triggers, and management options for POTS, complemented by a quiz designed to help you if you’ve found yourself asking, “Do I have POTS Syndrome?”
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Do I Have POTS Syndrome? Quiz
Please note: This self-assessment is not intended to establish a physician-patient relationship, to replace the services of a trained physician or health care professional, or to otherwise be a substitute for professional medical advice, diagnosis, or treatment. The aim of this quiz is to provide education about the condition. By filling out this self-assessment and clicking “Submit,” you acknowledge that you’ve read and agree with this statement and agree to re-origin’s Terms & Conditions.
How Does This POTS Syndrome Quiz Work?
This quiz is designed to help you identify potential symptoms of POTS. We recommend you reflect on your typical health experiences when answering. Taking our short quiz above will help you gauge the intensity of the symptoms you’re experiencing and use the results to make a more informed decision about seeking professional help.
For each of the following questions, you will be asked to select one of the following options to indicate the frequency of your symptoms: never, very rarely, rarely, occasionally, frequently, or always. Your unique answers will then be used to calculate your results and determine whether your symptoms are mild, moderate, or severe. Your results will show further unique educational information, and all results are strictly confidential.
At re-origin, we’ve helped hundreds of people with chronic conditions manage and decrease symptoms with brain retraining. By rewiring your brain’s response to symptoms, you can better manage your stress response and calm your nervous system. If you are ready to take your first step towards healing, learn more about our POTS Recovery Blueprint.
Looking for inspiration and a real-life account of managing POTS? Check out POTS Recovery Story: Autumn’s Journey from Illness to Healing, to learn about her journey through diagnosis, setbacks, and strategies used to reclaim health and a more positive outlook on life.
Understanding POTS Syndrome: Causes, Symptoms, and Diagnosis
Postural Orthostatic Tachycardia Syndrome, commonly referred to as POTS, is part of a group of disorders under the umbrella of orthostatic intolerance. The primary symptom used to describe POTS is an excessively increased heart rate upon standing due to blood pressure regulation issues; it is often accompanied by other symptoms related to standing upright, such as lightheadedness, dizziness, brain fog, and trouble focusing.1 Blood pressure issues and heart rate abnormalities are crucial indicators in a POTS diagnosis, often assessed through a standing test or head-up tilt table test.2
How is POTS Diagnosed?
According to an article in the Canadian Medical Association Journal (CMAJ), the diagnosis of POTS is based on the criteria below:3
- Heart rate increase: A rise of at least 30 beats per minute (40 in adolescents) within 10 minutes of standing.
- No major blood pressure drop: Blood pressure doesn’t fall by 20/10 mmHg or more when upright.
- Frequent symptoms when standing: Issues like lightheadedness, rapid heartbeat, shakiness, weakness, blurry vision, or fatigue that improve quickly when lying down.
- Lasting at least 3 months: Symptoms have been present for three months or longer.
- No other cause: The symptoms can’t be explained by another condition that causes a fast heart rate.
Diagnostic Tests
There are two most common tests used to diagnose POTS: the tilt table test and the standing test.4 Both are designed to measure how your heart rate and blood pressure respond when moving from lying down to an upright position. These tests can help confirm whether the body is showing the hallmark signs of POTS, such as an abnormal increase in heart rate without a significant drop in blood pressure. The general steps are outlined below to give you an idea of what to expect, but they should always be performed and interpreted by a qualified medical provider.
Tilt Table Test
- You’ll lie flat while baseline heart rate and blood pressure are recorded.
- The table is then tilted upright (about 70°) for around 10 minutes to see how your body responds.
- People with POTS may develop symptoms such as dizziness, nausea, sweating, or even fainting. If fainting occurs, the table is returned flat immediately.
- Afterward, you’re monitored while lying down again.
Standing Test
- After resting flat for 10 minutes, heart rate and blood pressure are measured while lying down.
- You then stand still for several minutes while these measurements are repeated. A diagnosis of POTS is considered if heart rate rises above 120 bpm while standing, or in adults, it increases by 30 bpm or more from lying to standing.
For a full list of diagnostic tests for POTS, you may refer to Testing for POTS from the non-profit organization, Standing Up For POTS.
Causes of Postural Tachycardia Syndrome
POTS is a condition that affects an estimated 1–3 million Americans. Researchers do not yet know the exact cause, but evidence suggests that it likely develops from a combination of factors rather than a single origin.
The COVID-19 pandemic has drawn increased attention to POTS, with many individuals reporting new symptoms after infection. This has raised questions (such as “Will post-COVID POTS go away?”) and underscored the urgent need for more research to clarify underlying mechanisms and treatment approaches.
Potential contributing factors include:
- Autoimmune Disorders: Some evidence suggests that POTS may be linked to autoimmune conditions, where the body’s immune system mistakenly attacks its own tissues, potentially affecting the nervous system.1
- Genetic Predisposition: There may be a hereditary component to POTS, indicating that genetic factors could play a role in its development.6
- Viral Infections: The onset of POTS has been frequently associated with viral infections, which can trigger autoimmune responses or directly impact autonomic nervous system function.2
- Physical Deconditioning: Extended periods of bed rest or inactivity can lead to deconditioning, which may precipitate or exacerbate the symptoms of POTS.
- Pregnancy: Changes during pregnancy can initiate POTS, possibly due to hormonal changes and changes in blood volume.2
Related: Learn which types of clinicians manage POTS, how care teams coordinate, and the innovative treatments that are emerging, see Who Treats POTS? Understanding the Best Care Options for You
POTS Symptoms Checklist
A POTS symptoms checklist can be used to track which symptoms of POTS you experience most often or are most severe, monitor changes over time, and share a clearer picture with your healthcare provider.
The symptoms of POTS are primarily related to the body’s inability to properly regulate blood flow and blood pressure. Thus, some of the common symptoms listed below are developed when upright and can be relieved by reclining.
A recent study showed that over 80% of POTS patients experienced the symptoms below:5
- Light-Headedness (Presyncope): Sensation of dizziness or like you may faint
- Palpitations: Heart beating quickly, which can be uncomfortable and distressing
- Shortness of Breath: Difficulty breathing or feeling winded, especially when upright
- Fatigue: Chronic, often debilitating fatigue that does not resolve with rest
- Brain Fog: Cognitive impairments, such as trouble concentrating and confusion
- Headaches and Migraines: Frequent or severe headaches that may worsen when standing
- Gastrointestinal Issues: Symptoms such as nausea, abdominal pain, and irritable bowel syndrome are commonly reported.1
- Muscle Pain or Weakness: Soreness, aching, tenderness, or loss of strength in the muscles
- Tremors: Shaking or trembling, particularly when in the upright position.
- Cold or Discolored Extremities: Hands and feet may appear purple, red, or pale due to blood pooling.
Other symptoms include:
- Fainting (Syncope): Loss of consciousness and muscle strength due to low blood flow to the brain
- Excessive Sweating: There can be abnormalities in sweating, either too much or too little.
- Chest Pain or Pressure: Discomfort that can mimic cardiac issues but is linked to autonomic dysfunction.
- Visual Disturbances: Blurred vision, tunnel vision, or temporary vision loss upon standing.
- Sleep Problems: Insomnia, restless nights, or non-restorative sleep.
- Exercise Intolerance: Symptoms that worsen after physical activity, sometimes persisting for hours or days.
How Long Does A POTS Flare Up Last?
For people living with Postural Orthostatic Tachycardia Syndrome (POTS), flare-ups can be unpredictable and disruptive. Some episodes may resolve within hours, while others can last for days or even weeks, depending on triggers, overall health, and management strategies. While there’s no single timeline that applies to everyone, certain factors can strongly influence how long a flare lasts and how severe it becomes.2
Several factors can influence the length and severity of POTS flares:
- Hydration and Salt Intake: Proper hydration and proper salt intake can help maintain blood volume, which is crucial for stabilizing blood pressure and heart rate when standing. This management strategy is essential to reduce POTS symptoms and shorten the duration of flare-ups.1
- Treatment Efficacy: The success of both medical and non-medical treatments can affect how quickly symptoms are alleviated. Implementing strategies like wearing compression stockings to support blood vessels and engaging in appropriate exercises can stabilize the condition more swiftly.
- Response to Initial Symptoms: How promptly individuals respond to the onset of symptoms by taking actions such as lying down, cooling down, or hydrating can also impact flare duration.
Non-Medicinal Treatments for POTS
Non-medicinal treatments for Postural Orthostatic Tachycardia Syndrome (POTS) focus on lifestyle modifications and physical interventions that help manage and alleviate the symptoms associated with this autonomic disorder. Many people ask, “Can you treat POTS without medication?” The answer is that these interventions are particularly important as they offer alternatives or complements to pharmacological treatments, addressing the symptoms at their physiological root without the potential side effects of medications.
Brain Retraining Programs
Brain retraining, or self-directed neuroplasticity, is emerging as a potentially useful tool in treating POTS, particularly in cases where autonomic nervous system dysfunction plays a significant role in worsening symptoms. Through consistent practice, these methods can help rewire the brain’s responses to stress and positional changes, potentially improving the regulation of autonomic functions. Cognitive-behavioral approaches and mindfulness practices also fall under this category, helping patients manage the anxiety and stress that can exacerbate POTS symptoms. You can learn more about brain retraining and start your healing journey with our POTS Recovery Blueprint.
Increased Salt and Fluid Intake
One of the foundational non-medicinal strategies for managing POTS involves increasing salt and fluid intake. This approach aims to expand blood volume, which can be significantly lower in POTS patients. An increased blood volume helps maintain blood pressure and reduce heart rate increments upon standing, thereby lessening the orthostatic intolerance that characterizes POTS. Patients are often advised to consume a high-sodium diet, coupled with the intake of additional fluids to ensure hydration. This can be particularly effective in types of POTS where hypovolemia (low blood volume) is present.2
Physical Therapy and Structured Exercise
Physical therapy and a structured exercise program are critical components in treating POTS, especially given the direct impact of physical conditioning on cardiovascular and autonomic nervous system functioning. Starting with recumbent or horizontal exercises—such as rowing, swimming, or recumbent bicycling—helps the body readjust without the immediate challenge of gravity. Gradually, as tolerance develops, more upright exercises can be incorporated. Regular physical activity helps improve blood flow, strengthen the heart, and enhance the body’s ability to regulate blood pressure and stabilize heart rate during positional changes.1
For examples of gentle physical activity, read Somatic Exercises: The Ultimate Guide to Enhancing Your Well-Being.
Compression Garments
Wearing compression stockings or garments is another effective non-medical treatment. These garments help by exerting pressure on the legs, promoting blood flow back to the heart, and reducing the amount of blood that pools in the lower extremities. This can significantly help with heart rate and blood pressure stabilization to decrease symptoms like lightheadedness and fainting upon standing.
For more non-medicinal treatments for POTS, read How To Treat POTS Naturally next.
Enhance Your Quality of Life by Understanding and Managing POTS Symptoms
Understanding and managing Postural Orthostatic Tachycardia Syndrome involves recognizing the symptoms, triggers, and effective treatments that can significantly enhance your quality of life. If you believe you might have POTS, reach out to your primary care physician for professional advice and a personalized management plan. Remember, effective management can help most patients achieve a better quality of life despite the challenges of this disorder.
At re-origin, we help you reclaim your health by rewiring your brain. By changing the way you respond to your POTS symptoms, you can slowly rewire your nervous system responses, allowing your brain to feel safe and decreasing the intensity of symptoms. If you’d like to take the first step on your healing journey, purchase our POTS Recovery Blueprint today.
